The GDC's main remit is to protect patients. This is something we respect and agree with. However here are 10 reasons I feel that they are not achieving their defined purpose:
1. Undergraduate education deterioration... They oversee undergraduate education. They check curriculums and dental schools. It is obvious that undergraduates are qualifying with fewer skills. Universities and hospitals are inundated with bureaucratic workloads making hands-on teaching almost impractical. When these undergraduates cannot gain the relevant competencies, how can they treat patients easily upon graduation? The GDC allows this to pass.
2. The universities are now under pressure to fund themselves with limited government support. They have a cap on fees. Fee-paying students expect a certain standard and part of that is a fear to fail someone irrespective of their incompetence. It is harder to justify failing someone than it is to pass them. The GDC, which oversees education, allows this to pass.
Addendum. I am informed (from a former head of school) that dental schools and head of schools do have a responsibility to public welfare. They would fail a student who is not at the adequate standard. Furthermore the loss of funds is very low and washes out in the total budget.
This raises the question as to why students who are passed are considered to be less clinically competent from so many anecdotal reports we hear?
This raises the question as to why students reach out to social media and the world web to get direction on clinical methods?
This raises the question as to why in Scotland all students had to re do their year (due to COVID restrictions) and why those in England did not ?
The total budget for the university may wash out , but the 9000 a year the student has to pay is not washed out.
3. These students become dental professionals (GDC registered dental professionals) and enter the NHS system that is so ingrained in complications, bureaucratic workloads, and restrictions that the limited experience is continued. The GDC doesn't take any feedback on these shortcomings or at the very least, raise awareness of these issues to the relevant authorities (as a matter of principle).
4. Dentists who choose to do DF1 are hampered by a limited funded Health Education England who themselves have placed more bureaucratic loads and restrictions. The frustration is felt (ask the ESs). The GDC doesn't report the shortcomings or restrictions of HEE or at the very least, raise awareness of these issues to the relevant authorities (as a matter of principle).
5. A frustrated dentist eventually has limited skills in a limited system and feels exposed and vulnerable to the highly complaining and litigious culture ingrained in the public. They are forced to practice defensive dentistry. This doesn't protect patients and denies them the right care.
6. The dentist has to write bundles of notes to prove themselves. The GDC in any FTP case approached it like the dentist is guilty before proving their innocence. A scared dentist, a worried dentist is not in the right state to see patients. The GDC indirectly affects patient care.
7. The dentists, in their quest to upskill to be able to help serve patients, aims to undertake postgraduate training. Since 2006, the GDC has not registered postgraduate qualifications. They don't make any attempt to quality assure courses. The amount of CPD and postgraduate courses has expanded exponentially. Some of these have poor frameworks, standards, or structure and can yet award qualifications. In their pressure to keep up incomes, amidst all this competition, the universities now charge huge amounts for postgraduate qualifications and again are scared of failing or reprimanding poor students - scared of losing income. The education quality drops which affects patient care. The GDC is not reinstating this and affecting patient care.
8. Dentists get awards that are not truly representative. 'The best X dentist in the South-East' is misleading. The GDC don't like misleading advertising (as they've stated when someone presents themselves as specialists ) but does not do much about this. They are complicit in not protecting patients.
9. The GDC come down like a ton of bricks on dental professionals when they make an error. They could mitigate that by creating systems that help address an issue before it occurs. I believe the upstream regulation pathway may be aiming to address this.
10. The GDC monitors CPD. Yet they have previously created a tickbox culture by creating core subjects. This box-ticking has now been passed on to the GDC. Protecting patients comes from doing development that identifies shortcomings and a growth mindset through feedback, reflection, and relevant learning. The PDP is one step toward that but the hours-based system (combined with the CQC type box-ticking) doesn't enable growth. This in return, impacts patient care.
In true, bonus style - I thought I would add one more reason for those who have made the effort to read this all the way through (you see, I have been listening to all those marketers - the ones who talk about leads, conversions, and all that).
Bonus reason number 11: There are so many direct to patients orthodontic entities and illegal tooth whitening stands popping up faster than we can count. These are carrying out the practice of dentistry while not being registered. Yet the GDC has not done much about it.
As though all this is not good enough, the GDC does not take feedback constructively and blames legislation for tying their hands. If they truly cared, they have the ability to communicate with relevant government and parliamentary authorities to change that legislation OR at least bring it to their attention.
Have they done this?
Ultimately UK patients blame dentists, yet it is the regulator that has to carry some of that can... and so they should with their millions in reserves. They do have broader shoulders than most of us.